Contraception and Medical Costs

Today’s Managing Health Care Costs Indicator is 3.68

Today the NEJM  published on the web an article likely to incite a political argument.  Researchers from Princeton point out that the medical claims cost associated with unwanted pregnancies far exceed the medical claims costs for voluntary contraception.

In fact, they say that the public sector’s family planning costs are $1.9 billion annually, and medical savings (not including savings from other social programs) are $7 billion. That’s a return of investment of 3.68!

The authors argue that the Institute of Medicine should declare contraceptives to be part of the comprehensive range of preventive health services available to women at no charge under the Affordable Care Act.  The financial argument isn’t their only argument; they note that many women don’t use some of the most effective long-acting reversible contraceptives such as implantable devices and intrauterine devices, because they are expensive up front, even though they are very effective and cost less over time.  As a result, many women seeking to avoid pregnancy will choose either condoms, which are less reliable for pregnancy prevention, or oral contraceptives, which cost less up front but more over five years, and have more potential medical complications.

We should provide coverage for the full range of women’s health needs, and we should decrease barriers to the safest and most effective forms of contraception. This can prevent unwanted births, as well as prevent abortions.  The financial savings in medical claims are real – but they’re not the main reason to provide this coverage.